Laserfiche WebLink
APPLICATION FOR CONSTRUCT VN PERMIT <br />TO BE COMPLETED IN INK—PLEASE PRINT <br />tM Ewrpr9�� <br />everett � <br />BUILDING DEPARTMENT <br />259-8810 <br />"� DEMOLITION ❑ COMBINATIO <br />MAIL ADOHE55 <br />HEATING SYSTEM: GAS ❑ ELECTRIC ❑ <br />N � BUILDING �(MECHANICAL <br />PH <br />�o �l `��r�� s-� �� <br />CITY Z�P <br />CITY ZIP PN <br />CITY ZIP Ph <br />PLUMBING <br />'7� c _ r <br />everett <br />e <br />__ SIGN <br />CLASS OF M�K <br />� NEW ❑ ADDITION '�_ ALTERATION ❑ REPAIR ❑ DEMOLITION CI WOODSTOVE/FRPL INSERT G BUILDING FELOCA � <br />ICONTACT PEe�S�N ANO 7NONE NO <br />�.wto�rT PNICE OF WORK �� i l O � O <br />L07 BLOCN <br />FOR OFFICE USE ONLY: <br />cenurccTNSCN REAR! <br />USEZONE <br />ttVEOFCONI <br />SIZE OF Bll <br />OCCUPANC <br />REASON Ff <br />INT�NE BY <br />LOT �RF <br />i.ALLOWRBIF TVPEOfI <br />G. NO.OF <br />/LOAD FIRESi <br />R SPRINKLERS <br />PUNS <br />� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW 7HE SAME TO BE TrIUE AND COFiRECT. ALL <br />WORKSWILL EF OMPLETED WIDT'H WHET ERVSPECIFIED HE E N OR <br />NOT. THE GRANTING OF A PERMIT �OES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAI� I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO FERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND � COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />SIGN�NREOFCONTRACTORON�UTNORIZEOAGENT DATE <br />BUILDING <br />aCuvuKr xao�OWF0.MGuxrts <br />caauv PLUMBING <br />BnSEMEr+T MECHANICAL <br />HEIONT I�MITFTION hDDITIONAL PIAN CHECK <br />OTHER <br />STATE BUILDING SURChARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAI <br />